Town Square

Feature story: Palo Alto mom with a mission

Palo Alto resident Stephanie Martinson, a speech therapist and the mother of daughters at Palo Alto High and Ohlone Elementary schools, is on a mission to bring automated external defibrillators (AEDs) to schools and elsewhere. ==B Related story:== [Web Link A heart races, then stops]

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Posted by John Galt
a resident of Fairmeadow
on Jan 25, 2013 at 10:59 am

Excellent program, Congrats!
Please follow up by strictly following the maintenance program.
There have been far too many failures in AED use due to poor maintenance. You can't just hang them on the wall and "hope" they will work.
Research this issue to convince yourselves of the importance of maintenance.

Posted by KP
a resident of South of Midtown
on Jan 25, 2013 at 12:45 pm

I hope you can keep this program going - and, yes, make sure the maintenance is kept up.
My nephew died on the basketball court in Portland a few years ago - it was heartbreaking. His mother started a foundation and is trying to get every high school outfitted with these units.

Posted by Not-A-Good-Idea
a resident of Another Palo Alto neighborhood
on Jan 25, 2013 at 1:57 pm

Given that Palo Alto schools are all within one mile of a fire station, and that the response time for first responders is generally 4 minutes (plus or minus), it's a little difficult to believe that the school district would want to assume the liability of first response for anyone who happens to be on the school grounds.

There ought to be some reliable statistics available (for both California and the US) that would provide some sense of how often students/staff/guests suffer heart attacks while on a school campus. It's hard to believe that this happens very often--forcing school districts to be concerned about the need to provide this service. For school districts where first response is greater than four minutes--then this idea makes sense.

Hopefully the PAUSD will ask some hard questions of the people promoting this idea--such as producing the number of heart attacks on school sites over the past twenty years, or so. There also needs to be some information about the costs to the districts, in terms of outlays for hardware/training, and settlements that resulted from equipment failure. Keep in mind that law suits involving school districts result in settlements are often sealed, so that the public never knows why the equipment failed, or if there is any evidence that the school district was/is prepared to use this sort of equipment correctly during an emergency involving a cardiac event.

Along those lines, it would be interesting to see how many PAUSD teachers/staff have been certified in CPR—which does not require batteries.

Posted by Laila Craveiro
a resident of Midtown
on Jan 25, 2013 at 2:09 pm

Community involvement is part of a much needed jolt to the heart of almost all matters. Sudden cardiac arrest is a life-threatening problem that can be successfully addressed by non-medical responders and the use of AEDs. Racing Hearts is a great initiative. I hope to see this grass root movement taking new partners to grow strong.

Fire Station proximity means nothing to a victim who's heart may have been stopped longer than the "4 minutes" distance. A primary example would be finding a victim on the bottom of the pool - not having any idea how long the victim has been under.

Posted by Not-A-Good-Idea
a resident of Another Palo Alto neighborhood
on Jan 25, 2013 at 3:31 pm

&gt; How have you arbitrarily chosen 4 minutes as the ideal?

Arbitrarily chosen? Hardly.

Based on this comment, and the rest—this poster has probably not been exposed to any of the basics of “First Aid”. Sigh .. let’s go through the basics ..

Most people, without air, will die in about five minutes. Four minutes if pretty much the national standard (NFPA 1710): Web Link

for first response with any hope of saving the victim. While this is almost impossible to meet at the national level, it is not so hard to meet in small towns—like Palo Alto—and in large cities near fire stations.

Having taken CPR in college, as well as the military, four minutes is the always given as the target for “biological death”:

During my time in the military, I had occasion to administer CPR to someone who had undergone what something later identified as an “alcoholic seizure”. I was about twenty feet from this person, who was fine one minute, and keeled over the next. He was completely rigid, and not breathing.

Even though I was the ranking person in the room, and I had been through a rigorous CPR training course when I was in college—I found myself just staring at the man. As it turns out, he was not assigned to my unit, and no one knew who he was. At about two minutes, he started turning purple, and at/about four minutes, he started turning blue. It was at that time, I realized the was close to the “4-minute mark” and my CPR training kicked in. I order one of the GIs to start breathing into his mouth, and I started the “chest pump”. To my great relief, he started breathing again—just before the medics showed up, and took over.

Even though I had saved this man’s life—I felt awful because it took me almost four minutes to fully evaluate the situation, and get the CPR going. He did live, so my self-doubts were assuaged somewhat—but I realized that the training I had received in the military was not nearly as good as that I had received in college—in my SCUBA diving course.

My real life experiences with having been exposed to a life-and-death situation makes me wonder how many 1st and 2nd grade teachers that have trouble with PCs and other simple technologies would know anything about “clinical death”, “biological death” and the colors that provide the internal “clock” ticking off the minutes of the victim’s life.

I’m guessing that few teachers/staff in the PAUSD (or any school district) have ever been trained on “first aid basics”—which would necessarily include CPR.

&gt; All-in-all, you comments do not seem like well thought out ideas.

Well, I’ve provided a fair amount of information as to why I believe that most teachers/staff would not be likely to jump into action and use this equipment effectively. I would be interested in your response. Will you call me a liar—claiming my experiences are made up? Or that I could not possibly have come to the conclusions that I did—because you have no such experiences—and therefore you must know what you are talking about and I do not?

Posted by Not-A-Good-Idea
a resident of Another Palo Alto neighborhood
on Jan 25, 2013 at 3:54 pm

&gt; I'm sorry that you are projecting your proven inability,
&gt; through your claim not to help a dying man for 4 minutes,
&gt; onto others

I never said I knew he was dying and that I purposefully withheld aid. I simply said that it took that long ( a very short amount of time in reality) to recognize that he was in fatal duress. It is astounding that you would post this, while apparently not even knowing the difference between "clinical" and "biological" death!

I’m guess by your snide, and almost hateful responses, that you have no idea what I am talking about. I’m guess you are not the sort of person who ever served in the military, or ever had to make flash decisions that affected other people’s lives.

I did learn from the experience. But I see that it would not pay to provide you any more information as to how this experience affected other situations in which I found myself.

You claim at these devices save lives. Well, in the right hands, I have not doubt. But school teachers/staff are generally not the right hands. And as I pointed out, CPR would be the first step—because these devices are simply a tool, not a solution.

By the way, how many lives do these devices save on school campuses, every year, in the US?

Posted by a GREAT idea
a resident of Los Altos
on Jan 25, 2013 at 4:02 pm

"I simply said that it took that long ( a very short amount of time in reality) to recognize that he was in fatal duress." Yes, you told us you delayed action for 4 minutes, even though you claimed to be trained to do otherwise. Hence the comment: your proven inability to help a dying man for 4 minutes.

"You claim at these devices save lives." Did you even read the linked article?

I think this is great, and I commend this mom, knowing how many barriers she probably faced even to implement a good idea like this.

However, if she reads this, I would ask her to learn a bit more about allergies and asthma. The article says: "We do a phenomenal job with asthma -- we have EpiPens everywhere and they're mandated in our schools -- but we also need the same standard of care for sudden cardiac arrest."

EpiPens deliver epinephrine, which is an emergency treatment for anaphylactic allergy, not for asthma.

The California Department of Education says asthma is the leading cause of school absenteeism. It's difficult to get accurate statistics, but from what I gather from the county, we have a rate of asthma in Palo Alto middle schools that exceeds what it should be given the demographic. Prevention goes a long way with asthma, and PAUSD isn't yet dealing with this issue. We are doing much better about letting kids carry their inhalers in school, but we're doing badly at making those inhalers unnecessary for a good percentage of them as we could be doing.

I can't speak for parents of kids with anaphylactic allergies, for which EpiPens are required if they have an attack. Prevention is possible here, too, though in the case of asthma prevention means mostly good maintenance and indoor air quality measures, in the case of anaphylactic allergies, the steps are different and politically more difficult for parents depending on the school.

So, as someone who wants to bring good indoor air quality practices to PAUSD, I would say -- thank you for what you are doing, but please don't use that example!

Well, my hubby who had asthma as a child informs me that epipens are sometimes used in asthma when all else fails. But even so, to say we are doing a phenomenal job with asthma because we have epipens available is kind of like saying we do a phenomenal job with traffic safety because we have fast ambulances to haul the kids getting hit by cars everyday to the hospital. We can do things to reduce asthma attacks by half in our district, and we aren't yet making the effort.

Posted by Laura
a resident of another community
on Jan 27, 2013 at 6:59 am

It is great to see AED's being placed in more schools and available for sports activities. Keep up the great work. I'd like to mention a couple important points that many people might not be aware of... Sudden Cardiac Arrest(SCA) is not a Heart Attack. There are times that a heart attack can lead to a SCA, but SCA is due to "electrical" issue and heart attack is usually due to a blockage. Many of the "electrical" issues are hereditary, such as Long QT, CPVT, etc. They are caused by rare genetic mutations that get passed down. In my family, a genetic mutation (CPVT - Catecholimenergic Polymorphic Ventricular Tachycardia) has been passed down. I have it and both of my boys have it. We didn't know about it until our 17 yr old son had sudden cardiac arrest. Thanks to the quick action of his 4 friends, he not only survived, but did not have any brain damage. Although they did not have an AED available, they did call 911 and immediately start CPR. 2 of the boys had great CPR training at the YMCA for their lifeguard jobs. Our family has gone through genetic testing and the mutation was confirmed. In our case, a beta blocker is working really well at controlling the irregular heartbeats. I've always had a theory about allergies - lots of people think that fatal allergies are on the rise because of environmental changes, but I think that it is more because they are so hereditary and we've gotten so good at saving someone from an allergic reaction. In the past, they would have died and not passed on the genes, but now they live (thankfully) and pass the genes related to the fatal allergy (like peanuts) on to the next generation. I think it could end up being the same with the hereditary arrythmias. More people are surviving and passing on the genes. I think they will become less rare. I think that the current stats are 1 in 5000 for Long QT and 1 in 10,000 for CPVT. For CPVT, there is a 50% chance of passing it down to your child. It is not recessive, so only 1 parent has to have it to pass it. I've done quite a bit of research on arrythmias over the past couple years, and have seen mention arrythmias might be a contributing factor in many SIDS (sudden infant death syndrome) cases. I think that there will be an increase in reported deaths due to SCA because now that they are learning more about arrythmias, and genetic testing is becoming more available & affordable, many of the "death by unknown cause", will be attributed to a genetic arrythmia. Sorry to ramble, but I really believe that AED's are going to be even more needed than they are right now. And another point I wanted to mention is that people used to think that CPR wasn't helpful past a certain number of minutes, but research now shows that proper CPR (chest compressions only) can keep oxygenated blood flowing past the brain for a very long time. Think about some of those divers that can stay down for 20 - 30 minutes without air. That is because the blood still has oxygen in it. When someone suffers SCA, their heart isn't pumping any blood. The doctors/nurses that treated our son, said it is very unusual for someone to do CPR correctly (even with good training). To do it right, you've got to do it hard and fast and without stopping. As in, "breaking bones hard". I belong to an online support community (Inspire), and several people mention on there that they got so tired doing CPR, that they had to switch to "stomping" on the person's chest with their foot. (and it worked) People need to know that the "new" CPR doesn't require any real training. You can easily google the videos by typing in CPR and Stayin Alive. CPR standards were recently updated and I am pretty sure that mouth to mouth is now only recommended in drowning victim cases. Most local fire departments offer free Saturday classes on CPR. Everyone should take advantage of this. Sorry to go on and on, obviously this is near & dear to me.

Posted by Gunn Parent
a resident of Midtown
on Jan 27, 2013 at 2:08 pm

Thank you Stephanie and others for all your hard work on this. If placing AEDs in our schools only ever saved the life of one child (or adult) wouldn't it be worthwhile? Let's not get so paranoid about liability or second-guessing how people may or may not react in an emergency that we choose to not do things that may save people's lives. We are talking about dollars versus lives. I vote for saving lives. I like the approach by Stanford's Pena of sending out regular maintenance reminders.

Posted by RH Supporter
a resident of Los Altos
on Jan 28, 2013 at 10:13 am

Hats off to Stephanie Martinson for her tremendous work in helping to place AEDs throughout our communities. It is especially awe-inspiring to see her take such a personal issue and put her experience to good use by helping to protect others who face many of her same health problems. I expect this initiative to grow tremendously in the coming years. Congratulations, Stephanie and Racing Hearts!

Posted by parent
a resident of Old Palo Alto
on Mar 15, 2013 at 2:49 pm

What is the status of this program for PAUSD?

My brother-in-law is an athletic trainer at a big high school on the east coast. Just this last week, he was called to a PE class where a student had collapsed and had no heartbeat. With CPR and the AED, he was able to resuscitate the student after an excruciating amount of time. It took another 30 minutes after the medical team arrived to get him stable enough just for transport back to the Children's Hospital. (The student is now stable and undergoing care.)

We really should have these sprinkled around the middle/high school campuses. Our campuses are so broken up and sprawling that getting care when and where it's needed is not trivial.